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IT'S TIME FOR UNIVERSAL HEALTH CARE

 
 
High Seas
 
  1  
Reply Sat 8 Mar, 2008 01:04 pm
old europe wrote:
High Seas wrote:
Hi Old Europe - pls read the entire post before commenting:

The obese were number (1) the others are the ones mentioned under number (2), and the subject of your article. Smokers cost almost nothing.


Hello High Seas.

I did read the entire post. However, I only commented on the part of it that I quoted - the claim that obese people cost a health care system more money than healthy people.

I thought the results of the Dutch study were quite interesting in that regard, and somewhat counter-intuitive.

If you've been following the threads on universal health care on this forum, you'll have noticed that obesity has often been cited as a reason why per capita health care costs in America would be so much higher than in any other country - just as you claimed in your earlier post.


This is not claimed by me in either the post you cite or on any other I ever made.

I've access to actuarial date for well over 120 million persons worldwide in connection with my work; costs of health care for Americans, exclusively, is no part of any post I ever made either.

Your article, once again, refers to MY category (2) in my post, which I don't plan to repeat - perhaps you'll be kind enough to read it once more and see that your article and I are in perfect agreement Smile
0 Replies
 
old europe
 
  1  
Reply Sat 8 Mar, 2008 01:14 pm
High Seas wrote:
old europe wrote:
High Seas wrote:
Hi Old Europe - pls read the entire post before commenting:

The obese were number (1) the others are the ones mentioned under number (2), and the subject of your article. Smokers cost almost nothing.


Hello High Seas.

I did read the entire post. However, I only commented on the part of it that I quoted - the claim that obese people cost a health care system more money than healthy people.

I thought the results of the Dutch study were quite interesting in that regard, and somewhat counter-intuitive.

If you've been following the threads on universal health care on this forum, you'll have noticed that obesity has often been cited as a reason why per capita health care costs in America would be so much higher than in any other country - just as you claimed in your earlier post.


This is not claimed by me in either the post you cite or on any other I ever made.

I've access to actuarial date for well over 120 million persons worldwide in connection with my work; costs of health care for Americans, exclusively, is no part of any post I ever made either.

Your article, once again, refers to MY category (2) in my post, which I don't plan to repeat - perhaps you'll be kind enough to read it once more and see that your article and I are in perfect agreement Smile



High Seas, I'm not going to quote your post back to you. However, just a little earlier, you claimed that "the greatest costs to public health systems are due to (1) obesity".

If you had read the article (or listened to the NPR interview), you'd have noticed that it somewhat confirms your point number (2), but completely contradicts your claim number (1).


However, if you still stand by your claim that the greatest costs to health care systems are (apart from geriatric illnesses) due to obesity, I think it would be interesting for the discussion if you could link to material that confirms your claim.
0 Replies
 
hamburger
 
  1  
Reply Sat 8 Mar, 2008 01:17 pm
an overview of U.S. health care and reasons for high cost published by NATIONAL COALITION ON HEALTH CARE .
it certainly does not paint a pretty picture .
no wonder people are waiting for medical "expeditions" to provide them with necessary healthcare .

Quote:
Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.


read the article here :
U.S. HEALTHCARE
0 Replies
 
High Seas
 
  1  
Reply Sat 8 Mar, 2008 01:18 pm
Certainly if by "obesity" you include the associated diseases (cardiovascular, internal organs, cancers, diabetes, etc) over the duration of the patient's life.

Actuarially the internal insurance companies' data are confidential but medically you can find literally petabytes of supporting evidence.

Did that answer your question?
0 Replies
 
High Seas
 
  1  
Reply Sat 8 Mar, 2008 01:19 pm
PS Hamburger, sorry, the post was addressed to Old Europe - hadn't seen your new post.
0 Replies
 
old europe
 
  1  
Reply Sat 8 Mar, 2008 01:58 pm
High Seas wrote:
Certainly if by "obesity" you include the associated diseases (cardiovascular, internal organs, cancers, diabetes, etc) over the duration of the patient's life.

Actuarially the internal insurance companies' data are confidential but medically you can find literally petabytes of supporting evidence.

Did that answer your question?



That did answer the question, but the findings of the study seem to come to a different conclusion - even though associated diseases and their costs were accounted for.

If you want to, you can read up on it yourself here: Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure.

Excerpt:

Quote:
Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.
0 Replies
 
Walter Hinteler
 
  1  
Reply Sun 9 Mar, 2008 04:49 am
American patients stay a lot shorter in hospital than patients do here: here, under our health system, the docors in the hospital decide that period, and not the insurence companies.
(There are some 'general guide lines', though, by the health insurers.)

I post this, since I've just read a report in today's Chicago Tribune about a proposed bill which would mandate that insurance companies cover a hospital stay for up to 48 hours after a mastectomy or lumpectomy, and 24 hours after a lymph node dissection.

Those patients stay here about one week in hospital, often longer.
0 Replies
 
mysteryman
 
  1  
Reply Sun 9 Mar, 2008 08:28 am
Walter Hinteler wrote:
American patients stay a lot shorter in hospital than patients do here: here, under our health system, the docors in the hospital decide that period, and not the insurence companies.
(There are some 'general guide lines', though, by the health insurers.)

I post this, since I've just read a report in today's Chicago Tribune about a proposed bill which would mandate that insurance companies cover a hospital stay for up to 48 hours after a mastectomy or lumpectomy, and 24 hours after a lymph node dissection.

Those patients stay here about one week in hospital, often longer.


Even if there is no medical reason for them to be in the hospital a week or longer?
0 Replies
 
Advocate
 
  1  
Reply Sun 9 Mar, 2008 08:44 am
MM, the point is that the doctor should decide this, not the insurance company.
0 Replies
 
mysteryman
 
  1  
Reply Sun 9 Mar, 2008 08:52 am
Advocate wrote:
MM, the point is that the doctor should decide this, not the insurance company.


I 100% agree.
But if the Dr decides that you need to stay in the hospital, even when there is no valid medical reason to, then isnt that Dr doing nothing more then making the hospital more money, at your expense?

That doesnt seem right to me either.
0 Replies
 
Advocate
 
  1  
Reply Sun 9 Mar, 2008 09:04 am
Are you saying that the insurance company is a better judge of medical necessity than is the doctor? I think I will give up.
0 Replies
 
mysteryman
 
  1  
Reply Sun 9 Mar, 2008 09:11 am
Advocate wrote:
Are you saying that the insurance company is a better judge of medical necessity than is the doctor? I think I will give up.


No, I'm not saying that.

I am responding to this comment...

Quote:
48 hours after a mastectomy or lumpectomy, and 24 hours after a lymph node dissection.

Those patients stay here about one week in hospital, often longer.


There is no valid medical reason for a person who has had a normal mastectomy or lumpectomy to stay in the hospital for a week or longer.
0 Replies
 
Walter Hinteler
 
  1  
Reply Sun 9 Mar, 2008 09:56 am
mysteryman wrote:
But if the Dr decides that you need to stay in the hospital, even when there is no valid medical reason to, then isnt that Dr doing nothing more then making the hospital more money, at your expense?


An intersting question.

So we would need someone, like an independent supervisor, who looks at the decissions any doctor makes.

And a committee, which overviews this supervisor.


I don't know how it works in the USA, but here medical judgements are generally made by the doctors. And they give the reasons qua their diagnosis and prescriptions. (Prescriptions here: stay in hospital.)

mysteryman wrote:
There is no valid medical reason for a person who has had a normal mastectomy or lumpectomy to stay in the hospital for a week or longer.



Well, until now no at all up to one day is in the USA - one week is thought here to be normal (by insurances).
Obviously, unvalid medical reasons, but accepted.
0 Replies
 
hamburger
 
  1  
Reply Sun 9 Mar, 2008 12:55 pm
mm wrote :

Quote:
But if the Dr decides that you need to stay in the hospital, even when there is no valid medical reason to, then isnt that Dr doing nothing more then making the hospital more money, at your expense?


if the patient knows that there is NO MEDICAL reason for staying any longer in the hosital , the patient is free to leave the hospital - or am i wrong ?

i am assuming that you believe the patient (or the insurance company) knows better what the MEDICAL reasons for staying in the hospital are than the doctor .

what i am reading into your comments - incorrectly perhaps - is , that in the U.S. at least some doctors want to keep the patient in hospital longer than necessary simply to fatten their paycheques .
would that not be considered unethical ?

indeed a rather curious (to put it mildly) medical system IMO .
HBG
0 Replies
 
cicerone imposter
 
  1  
Reply Sun 9 Mar, 2008 01:22 pm
hbg wrote: i am assuming that you believe the patient (or the insurance company) knows better what the MEDICAL reasons for staying in the hospital are than the doctor .


Or the patient. Good medical care includes the doctor listening to the patient.
0 Replies
 
Walter Hinteler
 
  1  
Reply Mon 10 Mar, 2008 01:16 pm
Coming back to a question from some time ago ...

georgeob1 wrote:
How is the German system different? Are doctors in Germany generally employees of hospitals or clinics or do they operate as independent agents in their own businesses or partnerships?

I recognize that in the UK and Canada doctors are mostly employees of the respective national health services.


Walter Hinteler wrote:
They are all employed, payed on tariff (in junior ranks), get a salary by agreement in the higher ranks.


It's tomorrow in our local paper (and this evening online):
- senior residents/specialist registrars (= doctors being on their five years period of becoming associate specialists/fellows) get 60,000€ ($92,000) gross salary (including four stand-by duties),
- associate specialists/fellows (= fully qualified specialists) get 80,000€ ($123,000) gross salary (including four stand-by duties).

For both: 42 hours/week regular working time, between 28 and 30 days vacancies (depending on age) etc

There's no difference on what discipline these doctors work or are specialised in.

(And since I've found the tariff online: a first senior physician gets 100,000€ = $154,000)
0 Replies
 
Miller
 
  1  
Reply Mon 10 Mar, 2008 03:51 pm
mysteryman wrote:


There is no valid medical reason for a person who has had a normal mastectomy or lumpectomy to stay in the hospital for a week or longer.


The length of stay in a hospital will depend on the specific medical case, the specific hospital, the specific attending physician, the age of the patient,
the medical history of the patient, and available social /health support to the patient on her release home from the hospital among many, many other variables ...
0 Replies
 
Walter Hinteler
 
  1  
Reply Mon 10 Mar, 2008 03:58 pm
Miller wrote:

The length of stay in a hospital will depend on the specific medical case, the specific hospital, the specific attending physician, the age of the patient,
the medical history of the patient, and available social /health support to the patient on her release home from the hospital among many, many other variables ...


Since I was referring here clearly to the situation in Germany, this response is .... well, not really how the situation is alike here.
0 Replies
 
hamburger
 
  1  
Reply Mon 10 Mar, 2008 04:01 pm
george wrote :

Quote:
I recognize that in the UK and Canada doctors are mostly employees of the respective national health services.


canadian physicians are NOT employees of the national(provincial) health services - even though most of their payments are received from OHIP (ontario health insurance plan ) .
they don't receive a "weekly/monthly paycheque" but are paid by OHIP for the patients they are treating a/t a fee schedule .
they may also charge the patient directly for any services not covered by OHIP .
hbg
0 Replies
 
Miller
 
  1  
Reply Tue 11 Mar, 2008 12:09 am
Walter Hinteler wrote:
Miller wrote:

The length of stay in a hospital will depend on the specific medical case, the specific hospital, the specific attending physician, the age of the patient,
the medical history of the patient, and available social /health support to the patient on her release home from the hospital among many, many other variables ...


Since I was referring here clearly to the situation in Germany, this response is .... well, not really how the situation is alike here.


My response was to MysteryMan.
0 Replies
 
 

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